ICMCC 2005 Public Health Vocabulary Tools to Facilitate ...


ICMCC 2005 Public Health Vocabulary Tools to Facilitate ...

ICMCC 2005

Public Health Vocabulary

Tools to

Facilitate International E-Health

Information Sharing

Focus on Communicable Disease


Michael L. Popovich

Scientific Technologies Corporation

Tucson, Arizona USA

However what message to leave ICMCC

attendees with?

• Population based registries

• Immunization tracking


• Event driven registries

• Disease reporting

• Communicable / Chronic

• Injury surveillance

• Early warning systems

• Syndromic surveillance

• Case Management

• Outbreaks

• Chronic disease

• PHIN standards and how they are

applied to public health applications

• Messaging HL7


• E-health tools for linking diverse

data sets in public and private


• Master Patient Indexing


• Value of E-Health E

Standards in


• Architectures and diagrams?

• Specific project lessons


Public Health ICT Examples?



First about ICMCC

• The ICMCC Community will make

a difference

• Building Capacities

• Sharing Global Knowledge

• Patients

• Providers

• Payers

• Projects

• Source of Excellence & Innovation

• Incubator for ideas and projects

• Second about Health Care ICT

• Just when you think you have

developed the perfect IT solution

something change

• Source be for ICT knowledge?

Lets return to PH IT

The Perfect Solution?

Example Public Health IT Applications


Use of standards & tools

Public Health Information Network


Immunization Tracking Systems

• 2 nd Population based


• 1 st Vital records

• Driven in 1993 by a

desire to improve

immunization rates

• IT evolved from Client

Server to Web-based


• Early standards work

• Date Elements and


Communicable Disease

Reporting Before 9-119

>80 Notifiable disease


Case Mgt. at local

level, individual tools

Communicable disease Reporting the

Next Generation of ICT

New Focus – timely and accurate

Electronic exchange

Standardized data

Use of latest IT

Web, HW, SW,

Tools, Flexible

• Also all notifiable


• Bioterrorism

• Smallpox

• Anthrax

Public Health ICT for

Communicable Diseases

1. Early warning of outbreaks

2. Accurate reporting of disease data

3. Information based decision tools to

support outbreak management

4. Evaluation of actions to enhance future


Data Information

Electronic exchange Communication

Minimize the impact Health & Economic

Capacity Building and Preparedness

Infrastructure Trained & Resources

Public Health Information Network

• Designed to create standard

architecture for information sharing

• E-health of public health

• 2002 began in U.S.

• Standards groups specific to

• Messaging

• Electronic exchange (Health Level 7 - HL7)

• Data standards for lab and disease reporting


Early Warning for Outbreaks

Data Analysis


Data Capture

Data Pre-Processing

Accurate Reporting of Disease Data

Decision Support Tools


(dynamically changing with

changes in PH status

and incoming data)

Public Health Status

(dynamically changing with

changes in incoming data)

Outbreak Management,

Contact Tracing and Case Investigation

Just when we thought we had a

good system

China SASR Cases Map 5-18-03

SARS 2004: China CDC Institute of Virology

1 st case: 4-22-2004

9 cases up to May 20 th

1 death.

First 2 cases from NIV.

NIV closed 4-23.

Computer donation?

Was there a source for ICT? NO!

Case Investigation and

Vocabulary Inconsistencies Problem

for Epidemiologists

• Changing Questions i.e. SARS

• "Have you visited Hong Kong in the last 10 days?“

• Followed 2 days later by "Have you visited Hong Kong

or Guangzhou Province in the last 10 days?“

• Followed 3 days later by "Have you visited Hong Kong,

Guangzhou Province, Hanoi, or Bangkok in the last 10


• Again followed a few days later by: "Have you visited

Hong Kong, Guangzhou Province, Hanoi, Bangkok, or

Toronto in the last 10 days?"

New Tools Were Required to Support Emerging Disease

Case Management…Was there a source of knowledge?

No!! There was not even a source of Epidemiology

knowledge in the disease

SARS Surveillance Efforts In China

New ICT Tools for Rapid Response

Form Builder


FormBuilder Tool










Questions Available become coded concepts expressed in a PHIN

Vocabulary Data Set (VADS)

• Example: Date Of Birth?

Application Code:


Source Code System:

CDC Standard Questions

Standard Description:

Date Of Birth

Data Type:


Date (range between 1890 and

Electronic Exchange

HL7 Messaging Type: DT

• Linking common questions is referred to as a

vocabulary module

• “nested” value sets expressed in PHIN VADS

• Example: Application Integration

Value Set Name:



A Movie

• ICT in a Changing Environment

• How an Immunization Tracking

System is Now used to Support

• Outbreak Management

• Emergency Preparedness

And will still support the primary mission


• Applications in Health Informatics May Address a Well Defined Problem but

Expect Change

• It is also impossible to plan for every future requirement


• Where will be the knowledge base be to support Health informatics s dissemination

of information?

• Where will others go for lessons learned and new technologies?

• Where will research and innovation in ICT be centered?

• Where will results of medical and health IT advancements be shared?

It will come from the contributions of the global members and resources of the

ICMCC. We have the opportunity to make a difference. We have the opportunity

to impact the quality of life by undertaking the challenges offered in patient

Medical and Care Compunetics.


• Michael L. Popovich


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